Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 0101036584 | VA |
NPI | 1013908466 |
---|---|
Provider Name | Dr. Timothy Andrew Presnell |
First Address | Richlands, VA 24641-1100 |
Second Address | Richlands, VA 24641-1102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2005 |
Last Update Date | 10/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003269 | ANTHEM BCBS (01) | |
0092140-000 | (05) | WV |
160047039 | RAILROAD MEDICARE (01) | |
6230857 | (05) | VA |
64664584 | (05) | KY |
B09553 | (02) |